A physical therapy functional assessment of a geriatric patient is one aspect of a comprehensive evaluation that determines the patient's physical, psychological and social needs. The information obtained allows a multidisciplinary team to develop a plan to maximize the individual's ability to function independently. The physical therapy functional assessment includes an elderly patient's ability to walk, balance and transfer from one place to another.
Procedure
The patient's physician often initiates a geriatric rehabilitation assessment after observing potential health and physical problems. A professional team, including a physician, rehabilitation nurse, physical therapist, occupational therapist, psychologist and medical social worker, completes a comprehensive assessment and sets a treatment program in motion. The physical therapist uses a variety of measurements to determine a patient's mobility, balance, range-of-motion, strength and endurance. She also evaluates factors, such as the person's method of ambulation, or method of moving from place to place, ability to transfer from a bed to a wheelchair and capacity to get into and out of a car or bed. Following the evaluation, the physical therapist formulates individualized goals that include exercises and improved methods of ambulation.
Selecting Assessments
The physical therapist seeks to determine the most effective therapy strategies to improve the functional independence of a geriatric patient. Therefore, selecting an appropriate measurement tool weighs heavily in the establishment of an optimal treatment plan. Before selecting an assessment, the physical therapist must consider factors, such as the individual's health and residence, whether that is a community dwelling or institution. The June 2001 edition of the journal "Physical Therapy" recommends choosing a reliable, valid and practical assessment. For instance, the physical therapist must ensure that the test measures what it is designed to measure. The physical therapist must also consider the testing time required and the cost of equipment, along with the amount of space needed to complete the test.
Functional Assessments
A number of tests can help determine the ability of elderly patients to physically perform the daily activities necessary for independent functioning. The Physical Performance Test measures physical functioning, screens for falls and can indicate a patient's need for institutionalization or possible death. The nine-item version of this test includes simulated eating, dressing, turning 360 degrees while standing, retrieving a penny, walking 50 ft. and stair-climbing tasks. The Physical Performance Test takes only 10 minutes and requires few props. Another functional measurement, the gait speed test, times the patient as he walks at a routine pace over a known distance. The Six-Minute Walk Test, which assesses exercise tolerance and endurance, entails measuring the distance a person can walk in six minutes.
Additional Functional Measurements
The quality of an elderly person's life relates closely to his functional independence, according to the December 1995 issue of "Mayo Clinic Proceedings." Several additional functional assessments exist to assist the physical therapist in her development of a program to enhance a geriatric patient's life. One such test, the Functional Status Questionnaire, entails a self-reported measure of an ambulatory patient's physical, psychological and social functioning. Administering this test takes only 15 minutes. The timed-chair rise helps determine the patient's functional mobility, lower-extremity muscle force and balance. To complete this assessment, time the patient as he rises from a standard chair without the support of the chair arms. If a patient can stand up, he receives a grade of "able." Those who cannot stand receive a grade of "unable" and repeat the test using the chair arms for support.
